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杂交或全自然腔道内镜手术进行犬卵巢切除术:技术可行性研究与疼痛评估

Canine ovariectomy by hybrid or total natural orifice transluminal endoscopic surgery: technical feasibility study and pain assessment.

作者信息

Linhares Marcella Teixeira, Feranti João Pedro Scussel, Coradini Gabriela Pesamosca, Martins Letícia Reginato, Martins Arthur Rodrigues, Sarturi Vanessa Zanchi, Gavioli Felipe Baldissarella, Machado Silva Marco Augusto, de Ataíde Michelli Westphal, Teixeira Luciana Gonçalves, Brun Maurício Veloso

机构信息

Department of Small Animal Clinical Sciences, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.

Universidade Federal de Goiás, Goiânia, Goiás, Brazil.

出版信息

Vet Surg. 2019 Jun;48(S1):O74-O82. doi: 10.1111/vsu.12900. Epub 2018 Jun 13.

Abstract

OBJECTIVE

To compare technical feasibility, surgical time, surgical complications, and postoperative pain in ovariectomy (OVE) by hybrid and total natural orifice transluminal endoscopic surgery (NOTES).

STUDY DESIGN

Prospective randomized clinical trial.

ANIMALS

Sixteen healthy and sexually intact bitches.

METHODS

Dogs were randomly assigned to the hybrid NOTES group (HNG; n = 8) and the total NOTES group (TNG; n = 8) to compare surgical time, pain scores and complications. Pain was assessed by using the visual analog scale (VAS) and the Melbourne pain scale (MPS).

RESULTS

Surgical time did not differ between the experimental groups (HNG = 46.3 ± 18.5 minutes, TNG = 54.6 ± 31.1 minutes). Exteriorization of the ovaries through the vaginal wound was the major difficulty. Complications were minor in both groups and occurred intraoperatively only in the HNG, and in both groups post operatively. No dogs required rescue analgesia in the intraoperative or postoperative period. There were no differences in VAS or MPS scores between the groups for any surgical times except for the VAS assessment at 72 hours after extubation (HNG = 1.1 ± 0.3, TNG = 0.7 ± 0.4, P = .0221).

CONCLUSION

Both NOTES techniques were comparable for canine OVE, with no requirement for additional analgesia in the postoperative periods. It was not possible to determine whether there was a clear advantage of one technique rather than the other.

CLINICAL SIGNIFICANCE

The minimally invasive techniques proposed for laparoscopic OVE are feasible for dogs with low pain scores and low rates of complications for both groups.

摘要

目的

比较杂交式与全自然腔道内镜手术(NOTES)行卵巢切除术(OVE)的技术可行性、手术时间、手术并发症及术后疼痛情况。

研究设计

前瞻性随机临床试验。

动物

16只健康且性成熟的母犬。

方法

将犬随机分为杂交NOTES组(HNG;n = 8)和全NOTES组(TNG;n = 8),比较手术时间、疼痛评分及并发症。采用视觉模拟量表(VAS)和墨尔本疼痛量表(MPS)评估疼痛。

结果

实验组间手术时间无差异(HNG = 46.3 ± 18.5分钟,TNG = 54.6 ± 31.1分钟)。通过阴道创口将卵巢引出是主要难点。两组并发症均较轻,HNG仅在术中出现并发症,两组术后均有并发症。术中及术后均无犬需要急救镇痛。除拔管后72小时的VAS评估外(HNG = 1.1 ± 0.3,TNG = 0.7 ± 0.4,P = 0.0221),各手术时间点两组间VAS或MPS评分无差异。

结论

两种NOTES技术用于犬OVE效果相当,术后均无需额外镇痛。无法确定一种技术是否明显优于另一种。

临床意义

所提出的用于腹腔镜OVE的微创技术对两组疼痛评分低且并发症发生率低的犬是可行的。

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